Intelligent Mobile Application for Autism Detection and Level Identification System Using Deep-Learning Model

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Advanced parental age has been associated with autism spectrum disorders (ASDs) in children. However, little is known about the association between grandparental age at the time of birth of the parent and the risk of ASD in the grandchildren. To estimate the associations between parental and grandparental age and ASD risk in children. This population-based, multigenerational cohort study used data from Danish national health registries. A parental age cohort was constructed to evaluate the association between parental age and ASD in 1 476 783 singleton children born from 1990 to 2013, and a multigenerational cohort was also constructed including 362 438 fathers and 458 234 mothers born from 1973 to 1990 for whom information on grandparental age was available. Data analyses were conducted from November 1, 2018, through February 7, 2020. Parental age at childbirth and grandparental age at the time of the birth of the parent. Diagnoses of ASD in children were obtained from the Danish Psychiatric Central Register (1994-2017). Logistic regression analysis was used to estimate the associations between parental or grandparental age and ASD in children. Of the 1 476 783 children born from 1990 to 2013, 758 066 (51.3%) were male, and 27 616 (1.9%) had ASD (20 467 [74.1%] were male). Advanced paternal or maternal age over 30 years was monotonically associated with increased ASD risk, with odds ratios (ORs) of 1.56 (95% CI, 1.45-1.68) for maternal age 40 years and older and 1.57 (95% CI, 1.39-1.78) for paternal age 50 years and older, compared with parents aged 25 to 29 years. In the multigenerational cohort, 9364 grandchildren (1.7%) had ASD. This study found U-shaped associations, in that ASD risk was higher among grandchildren of younger (≤19 years) maternal grandmothers (OR, 1.68; 95% CI, 1.52-1.85), younger maternal grandfathers (OR, 1.50; 95% CI, 1.26-1.78), and younger paternal grandmothers (OR, 1.18; 95% CI, 1.04-1.34), and older (≥40 years) paternal grandmothers (OR, 1.40; 95% CI, 1.03-1.90) compared with the grandchildren of grandparents who were aged 25 to 29 years at the time of giving birth to the parents. These findings corroborate previous studies suggesting that advanced parental age is independently associated with increased ASD risk in children. This study also found that children with young maternal grandparents and children with young and old paternal grandparents had elevated ASD risk. Possible transmission of ASD risk across generations should be considered in etiological research on ASD.

Early diagnosis and intervention in children with autism spectrum disorder (ASD) is crucial. At present, diagnosis of ASD is primarily based on subjective tools. Identifying metabolic biomarkers will aid in early diagnosis of ASD complementing the assessment tools. The study aimed to conduct targeted metabolomic analysis and determine the plasma metabolites that can discriminate children with ASD from typically developing children (TD), and to determine the utility of machine learning in classifying ASD children based on the metabotypes. This was a multi-centric, analytical, case-control study conducted between April 2021-April 2023. Fasting plasma samples were obtained from seventy ASD and fifty-eight TD children, aged 2 to 12 years. Samples were quantitively analysed for 52 targeted metabolites (13 amino acids, 37 acylcarnitines, adenosine and 2-deoxyadenosine levels) using tandem mass spectrometry. An in-depth statistical analysis was performed. A total of 26 metabolites (11 amino acids, 14 acyl carnitines and adenosine) were found to be significantly (p < 0.005) different between ASD and TD children. Adenosine and amino acid levels were significantly decreased in ASD children. Among acyl carnitines, short- and long-chain acyl carnitine levels were significantly decreased, while medium-chain acyl carnitine levels were significantly increased in ASD children. Octenoylcarnitine-C8:1 (Cut-off value- 0.025 mmol/L, AUC- 0.683) and adenosine (Cut-off value- 0.025 mmol/L, AUC- 0.673) were found to predict children with ASD at a sensitivity of 55.7% and 57.1%, specificity of 79.3% and 72.4% respectively. Based on the metabolites, machine learning models like Support Vector Machine (SVM) and Random Forest (RF) were able to discriminate ASD from TD children with the classification accuracy score being highest in RF (79.487%, AUC- 0.800). Significant abnormalities in plasma metabolites were observed leading to disturbances in the Krebs cycle, urea cycle and fatty acid oxidation, suggesting mitochondrial dysfunction that may possibly contribute in the pathobiology of ASD. Octenoylcarnitine-C8:1 and Adenosine may serve as potential metabolic biomarkers for ASD.

This study prospectively assessed whether positive screening surveys for autism spectrum disorders (ASDs) in children with functional defecation disorders (FDDs) accurately identify ASD. Parents of children (4–12 years) who met Rome III criteria for functional constipation (FC), FC with fecal incontinence (FI) and functional nonretentive FI (FNRFI) completed two ASD screening surveys. Children with positive screens were referred for psychological evaluation, and a year later, follow-up surveys were conducted. Of the 97 study participants, 30.9 % were diagnosed with FC, 62.9 % with FC with FI, and 6.2 % with FNRFI. ASD surveys were positive for 27 children (27.8 %). New DSM diagnoses were made in 10 out of the 15 children that completed further evaluation. Two (2.1 %) met criteria for ASD, and 12 (12.4 %) met criteria for other behavioral disorders. Average SRS and SCQ-L scores were higher in subjects with FC with FI as compared to FC alone and in those who reported no improvement versus those who reported improvement 1 year later.Conclusion: While positive ASD screening surveys did not correctly identify ASD in the majority, it did help to identify other unrecognized behavioral disorders in children with FDD. High screening scores were more common in children with FC with FI and in children with poorer responses to current medical treatments.What is Known:•A prior study found that 29 % of children with FDD scored positive on ASD screening questionnaires.•Whether positive screens correctly identify ASD in children with FDD is unknown.What is New:•This study shows that positive ASD screens do not correctly identify ASD in children with FDD. However, the use of ASD screening questionnaires can identify previously unrecognized and untreated behavioral/developmental disorders in children with FDD.•High screening scores are more common in children with FC with FI and in children with poorer responses to current medical treatments.

This chapter explains the goals and techniques used in floor-time play therapy and how such goals and techniques serve to help the holistic development of Autism Spectrum Disorder (ASD) children. ASD children are often fixated on sensorial and repetitive play. Children diagnosed with ASD show specific traits in their play. Based on clinical observation, the most noticeable quality seen in ASD children's play is its lack of imagination and creativity and its repetitive nature. ASD children also have less variety in functional play, showing more repetition. ASD children play with their toys in a very rigid manner. They lack pretend and imaginative play. Sensory motor play will dominate the ASD child's play, and hinder him or her from engaging in symbolic play. Children with ASD show abnormalities in the first stage of play, which often produce developmental delays in the other phases. The adult interacting with the ASD child can be a therapist, a caregiver, or another significant adult.

With estimates of prevalence between 1 in 68 and 1 in 88 children [11], accurate and early identification of autism spectrum disorders (ASDs) in young children remains a pressing public health issue. In the absence of a single biomarker for ASD, however, a diagnosis is currently reached on the basis of a portfolio of evidence assembled by various health care professionals, parents and educational specialists. Studies have shown that early diagnosis and subsequent intervention are key to a favourable prognosis for children with autism. Many families, however, experience long periods of time between appointments with health care professionals, thus delaying the diagnosis and subsequent access to support and interventions. In this paper, we consider the potential role of m-health software solutions in supporting the diagnosis and ongoing monitoring of ASDs in young children. We consider their application particularly within the context of the UK’s National Health Service. This paper also presents a review of some of the current literature on user-behaviour analysis software on mobile computing devices such as tablet computers and smartphones, along with some of the emerging m-health solutions for supporting the diagnosis of ASD in children.

Parents with autism spectrum disorder (ASD) children generally suffer from poor coping and an impaired quality of life (QoL). This systematic review investigates parenting stress, positive reappraisal coping, and QoL in parents with ASD children. A literature search was carried out for publications written in English on the selected investigation topics using five databases, namely, Scopus, PubMed, Wiley, ScienceDirect Online, and EBSCO. Only studies investigating or measuring parenting stress, positive reappraisal coping, and QoL in ASD were included. Our results indicate that parents with ASD children have high stress levels. This is associated with the ineffective use of coping strategies and a low QoL. Adaptive coping strategies are related to a higher QoL, whereas maladaptive coping techniques are related to a worse QoL. Positive reappraisal coping is negatively correlated to meaningfulness, and it is used by parents to change their daily routines in order to motivate themselves towards new and evolving goals in life. Finally, we found a significant negative correlation between parenting stress, positive reappraisal coping, and the QoL of parents with ASD children. Positive reappraisal coping as a strategy helps parents adapt to stress and was found to be a potential mediatory function between parental stress and QoL.

Introduction: Children and adolescents with autism spectrum disorder (ASD) appear to be at greater risk of excess weight gain. The aim of this systematic review and meta-analysis was to examine whether children with ASD have a greater prevalence of obesity and whether the prevalence of ASD is higher in children with obesity. Methods: We conducted a systematic search on PubMed, Scopus, and PsychINFO until May 21, 2021. We used the meta package in the R in order to calculate the pooled prevalence and relative risk of obesity in children with ASD. Results: We found 20 eligible studies investigating the prevalence of obesity in children with ASD, with the prevalence ranging from 7.9 to 31.8% and from 1.4 to 23.6% among controls. All but three studies originated from the USA. The proportion of children with obesity in ASD populations was 17% (95% confidence interval [CI]: 13–22). The relative risk of obesity in children with ASD compared with control children was 1.58 (95% CI: 1.34–1.86). There were no controlled studies reporting on the prevalence of ASD in children with obesity. Conclusion: Children and adolescents with ASD have a higher prevalence of obesity than healthy controls. There is a need for further prevalence studies of obesity in children with ASD, especially outside the USA, since the few European studies carried out have failed to show a significant difference between obesity prevalence in children with and without ASD. There is no knowledge at all regarding the prevalence of ASD among children with obesity.

Previous studies have found that Autism Spectrum Disorder (ASD) children scored lower during a Go/No-Go task and faced difficulty focusing their gaze on the speaker’s face during a conversation. To date, however, there has not been an adequate study examining children’s response and gaze during the Go/No-Go task to distinguish ASD from typical children. We investigated typical and ASD children’s gaze modulation when they played a version of the Go/No-Go game. The proposed system represents the Go and the No-Go stimuli as chicken and cat characters, respectively. It tracks children’s gaze using an eye tracker mounted on the monitor. Statistically significant between-group differences in spatial and auto-regressive temporal gaze-related features for 21 ASD and 31 typical children suggest that ASD children had more unstable gaze modulation during the test. Using the features that differ significantly as inputs, the AdaBoost meta-learning algorithm attained an accuracy rate of 88.6% in differentiating the ASD subjects from the typical ones.

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder. Folate has been demonstrated to be associated with ASD. However, current studies on the correlation between folate and symptoms of children with ASD have inconsistent conclusions, use mainly small samples, and lack age-stratified analysis. This study aimed to explore the association between serum folate and symptoms of autistic children at different age groups from a multi-center perspective.Methods: We enrolled 1,300 children with ASD and 1,246 typically developing (TD) children under 7 years old from 13 cities in China. The Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Childhood autism rating scale (CARS) were used to evaluate the symptoms of children with ASD. China neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) scale was used to evaluate the neurodevelopment of children with ASD. Serum folate was measured by chemiluminescence assay in the two groups.Results: The serum folate levels of children with ASD were lower than that of TD children. In terms of core symptoms of ASD, we found that the serum folate levels were not associated with ABC, SRS, and CARS scores in ASD children of all ages but negatively associated with communication warning behavior scores of CNBS-R2016 in ASD children aged three and under. Concerning development quotients, it was at the age of three and under that serum folate levels were positively associated with gross motor, fine motor, language, and general quotient of ASD children. These ASD children aged three and under were further divided into two groups according to the median of serum folate (14.33 ng/mL); we found that compared to ASD children with folate ≤ 14.33 ng/mL, those with folate >14.33 ng/mL had lower communication warning behavior score and higher gross motor, fine motor, adaptive behavior, language, person-social, and general development quotients.Conclusion: We found that serum folate status was primarily associated with the neurodevelopment of children with ASD aged three and under. Furthermore, relatively higher serum folate levels may be more beneficial for children with ASD. Our results suggest that folate level should be paid more attention in ASD children, especially in early life, to better promote the intervention of ASD children.

Background: Narrative ability is a critical component of social communication essential for participating in everyday activities. Children with autism spectrum disorder (ASD) demonstrate problems in the narrative discourse, but little is known about the features of their fictional stories. Objectives: This study compared fictional narratives between ASD children and they’re typically developing (TD) peers. Methods: Fictional stories produced by 6- to-7-year-old males with high functioning autism (n = 14) were compared with language, sex, and age-matched TD children (n = 15). The stories were analyzed using the monitoring indicators of scholarly language. The macrostructure and microstructure elements, narrative complexity index, story knowledge index, and perspective-taking index were compared between the two groups by one-way analysis of variance (ANOVA) at the significance level of 0.05. Results: The scores of macrostructure and microstructure elements were lower in children with ASD. The ANOVA showed significant differences between ASD and TD children in three indices (P &lt; 0.05). Moreover, the Pearson correlation coefficients between the total macrostructure and microstructure scores were close to one in both ASD (r = 0.89) and TD children (r = 0.93). Conclusions: Despite obtaining scores in the average range in a standard language test, Farsi-speaking children with ASD experience limitations in fictional narratives.

Objective To explore the developmental characteristics of white matter volume in autism spectrum disorder (ASD) children longitudinal. Methods From May 2011 to September 2014, 37 ASD children (ASD group) and 27 developmental delays (DD) children (control group) were treated at the Child Mental Health Research Center, Nanjing Brian Hospital Affiliated of Nanjing Medical University, and the children whose age, gender and developmental quotient matched with the ASD children were scanned by structure magnetic resonance imaging (sMRI) at the age of 2-3 years old and 4-5 years old respectively.Region of interest(ROI) technology was adopted to investigate the change of the cerebrum white and the sub-lobes structure white matter volume with time.Then the correlation between clinical symptoms and brain white matter volume changes was analyzed. Results Among the 2-3 years old, compared with the control group, the white matter volume of the total brain[(383 521.84±6 427.57) mm3vs. (364 014.06±6 856.97) mm3], the left cerebral hemisphere [(191 609.35±3 206.60) mm3vs. (181 695.89±3 389.54) mm3], temporal lobe [(41 860.49±816.38) mm3vs. (39 444.18±834.85) mm3] and the right temporal lobe [(21 312.79±414.07) mm3vs. (20 084.22±412.13) mm3] were significantly larger in the ASD group, and the differences were statistically significant (all P 0.05). Among the 4-5 years old, compared with the control group, the white matter volumes of the total brain[(417 651.42±6 443.86) mm3vs. (394 317.27±6 404.86) mm3], left cerebral hemisphere [(208 714.16±3 214.61) mm3vs. (197 192.82±3 262.02) mm3], right cerebral hemisphere [(208 937.26±3 242.09) mm3vs. (7 124.45±3 193.13) mm3], frontal lobe [(107 107.46±1 681.99) mm3vs. (100 326.19±1 883.24) mm3], left frontal lobe [(54 569.63±846.85) mm3vs. (51 177.25±979.09) mm3], right frontal lobe [(52 537.83±841.99) mm3vs. (49 148.94±928.31) mm3], temporal lobe [(45 189.75±833.29) mm3vs.(42 487.73±786.27) mm3], left temporal lobe [(22 204.21±411.77) mm3vs. (20 922.90±418.46) mm3], and right temporal lobe [(22 985.54±426.93) mm3vs. (21 564.83±378.78) mm3] were significantly larger in the ASD group, and the differences were statistically significant (all P 0.05). For longitudinal analysis, there was a significant difference in the white matter volume between the whole brain, left cerebral hemisphere, right cerebral hemisphere, frontal lobe, left frontal lobe, right frontal lobe, temporal lobe, left temporal lobe, right temporal lobe and the differences were statistically significant(F=5.521, 5.533, 5.459, 5.830, 5.800, 5.723, 4.857, 4.418, 5.159, all P<0.05). There was a positive correlation between the changes of the volume of whole brain, the white matter volume in the whole brain, bilateral cerebral hemisphere, frontal lobe, parietal lobe, right parietal lobe and Childhood Autism Rating Scale(r=0.367, 0.343, 0.321, 0.349, 0.296, 0.308, 0.351, all P<0.05). Conclusions Among the 2-3 years old, the white matter volume of the brain regions have been increased significantly in ASD.Among the 4-5 years old, the increase of the white matter volume of the brain regions implicated more widely which mainly concentrated in the frontal and temporal lobe in ASD.The severity of the clinical symptoms of ASD may be associated with the white matter volume of the total brain, bilateral cerebral hemisphere, frontal lobe, parietal lobe and right parietal lobe. Key words: Autism spectrum disorder; White matter; Volume; Magnetic resonance imaging; Longitudinal study

Does IVF increase the risk of autism spectrum disorders (ASDs)? No association between IVF and ASDs or any of its subtypes was found in this sample. Certain prenatal factors may increase the risk of ASDs. Studies on the association between IVF and ASDs have shown inconsistent results. IVF is known to increase the risk of perinatal problems but many of them are related to multiple pregnancies. This case-control study included 4164 autistic cases and 16 582 matched controls born in Finland in 1991-2005. The cases were diagnosed with ASDs by the year 2007. The maximum age at diagnosis was 16 years. Four controls were matched to each case. For singletons the matching criteria were date of birth, place of birth, sex and residency in Finland. For twins the birth order within a twin pair was included as well. In the whole sample, there were 63 cases (1.51%) and 229 controls (1.38%) born after IVF. No significant association was found between IVF and ASDs (adjusted odds ratio (OR): 0.9, 95% confidence interval (CI): 0.7-1.3) or its subtypes childhood autism (OR: 0.8, 95% CI: 0.4-1.5), Asperger's syndrome (OR: 0.9, 95% CI: 0.5-1.6) or other pervasive developmental disorder (OR: 1.0,95% CI: 0.6-1.6). When only singletons were included, there was an association between IVF and Asperger's syndrome in an unadjusted analysis (OR: 2.0, 95% CI: 1.1-3.5) but this was not significant when adjusted for mother's socioeconomic status or parity. When the analyses were conducted separately for boys and girls, there was a significant association between IVF and Asperger's syndrome for boys in an unadjusted analysis (OR: 2.1, 95% CI: 1.2-3.7) but this was not significant in the final adjusted model. Information both on IVF and on ASDs was based on registers and it is possible that there is some misclassification. No information on different subtypes of IVF or other assisted reproduction techniques was available. Statistical power may have been insufficient. This study showed no increased risk of ASDs in children born after IVF but studies with larger sample sizes and information on different subtypes of IVF are needed to confirm the finding. The study was supported by Autism Speaks, NIMH 1K02-MH65422 and NIEHS 1R01ES019004. There are no competing interests.

The prevalence of sleep related complaints is reported by questionnaire studies to be as high as 83.3% in children with autism spectrum disorders (ASD). Questionnaire studies report the presence of various parasomnia in ASD. However, no polysomnographic study reports non-REM parasomnias and only a single study reports REM related parasomnias in ASD. We investigated the prevalence and characteristics of sleep disorders by polysomnographic study and questionnaires in a cohort of 23 children with ASD and 23 age-matched children of a non-autistic comparison group. The results showed significantly more non-REM parasomnias in 14 children with ASD on polysomnograms (PSG) and 16 ASD children by questionnaire, a finding that was not associated with medication use, other comorbid medical or psychiatric disorders, or sleep disordered breathing. Of the 14 children with ASD who had PSG evidence of parasomnia, 11 of them had a history suggestive of parasomnia by questionnaire. There was a high sensitivity but a low specificity of parasomnia in ASD by questionnaire in predicting the presence of parasomnia in the PSG. Of the parasomnias recorded in the laboratory, 13 ASD children had Disorders of Partial Arousal, consistent with sleep terrors or confusional arousals. Furthermore, multiple episodes of partial arousal occurred in 11 of the 13 ASD children who had PSG evidence of Disorders of Partial Arousal. Of the 11 ASD children with multiple episodes of partial arousal, 6 ASD children had multiple partial arousals during both nights' PSG study. Sleep architecture was abnormal in children with ASD, characterized by increased spontaneous arousals, prolonged REM latency and reduced REM percentage. These results suggest a high prevalence of parasomnia in this cohort of children with ASD and a careful history intake of symptoms compatible with parasomnia could be prudent to diagnose parasomnia in ASD children when performing a PSG is not possible.

Autism Spectrum Disorder (ASD) is becoming more prevalent among children worldwide. Three main issues that affect ASD children are behavior, communication, and social interaction. Children with special needs have the same right to engage in education, especially religious education. The main concern in delivering education to these special children is how to maximize their learning. They need teachers and parents to recognize their unique needs and abilities. ASD children have problems staying focused in learning. They are also not interested in lengthy content and linear materials such as books. Currently, the development of mobile applications is growing as many could benefit from it. This research will suggest a development of an Islamic educational mobile application for ASD children, which is built on the idea of enhancing visual and attentional skills based on play therapy. Since it is commonly known that children with ASD do not play in the same manner as regular children, the use of play therapy with ASD children has gained attention as a research topic. Auto play therapy is the term for the play therapy used with children who have ASD. The Mobile Application will include parent’s engagement as well for learning monitoring. This project was developed using Mobile Application Development Life Cycle (MADLC). The result and findings defined that most users agreed that this mobile application was easy to use, not complex, consistent, integrated well with elements and they are willing to use it frequently.